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2. FIRST NAME*
3. LAST NAME*
5. ADDRESS1*
7. ADDRESS2
9. CITY*
10. STATE*
11. ZIP*
13. EMAIL ADDRESS*
14. PHONE NUMBER*
16. Please let us know if you wish to participate in the 2023 Plant-A-Patch program at the Barclay Farmstead.
18. Question 1*

    1. Yes, I plan to garden in 2023.
    2. No, I do not plan to garden in 2023.
       (I understand that I am forfeiting any previous garden plots and would be considered a new gardener if I later change my mind.)
20. If you selected "No," please submit the form below.
24. RETURNING GARDENERS

    All returning gardeners should complete the remainder of this form, then click submit when finished.

26. Please click the link below to confirm your garden plot.
    Returning Gardener Plot List
28. Please select one.

    1. I would like to keep the SAME PLOTS as previously assigned in 2022.
    2. I would like to INCREASE my number of plots.
    3. I would like to DECREASE my number of plots.
30. INCREASE PLOTS

    Please indicate which plot(s) you would like added.

31. DECREASE PLOTS

    Please indicate which plot(s) you would like removed.

33. 2023 MEMO OF UNDERSTANDING
    2023 Memo of Understanding (PDF)

    Please be sure to read the 2023 Memo of Understanding.

35. Please complete this form by Friday, February 17, 2023.

    If you have any questions, please do not hesitate to reach out: 856-488-7868 or kjacobs@chnj.gov

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field